Coronary Calcification Detected by Electron-Beam Computed Tomography and Coronary Heart Disease: The Rotterdam Study.
We examined the association between coronary calcification detected by electron-beam computed tomography (EBT) and the presence of myocardial infarction, stratified for gender and age. We performed a cross-sectional study among elderly subjects, participants from the population-based Rotterdam study. Baseline data were collected in 1990-1993. During the third examination phase (1998-2000), subjects were invited for EBT scanning to detect coronary calcification. Calcified lesions were quantified according to Agatston’s method. Calcium scores were available for 1874 of 2263 subjects who underwent EBT scanning. A history of myocardial infarction was defined as the occurrence of a myocardial infarction before baseline or during follow-up but before EBT scanning.Mean age (SD) of the 997 women and 877 men was 71 (5.7) years. The calcium score showed a graded association with the presence of myocardial infarction. Compared to the lowest calcium score category (0 - 100), the age-adjusted odds ratio for myocardial infarction in subjects with calcium score > 2000 was 9.2 (95% CI 4.7 - 18.3) for men, and 10.0 (95% CI 3.4 - 29.8) for women. Additional adjustment for cardiovascular risk factors hardly changed the estimates. The association remained present in subjects above 70 years of age. In conclusion, in this population-based study, a strong association between coronary calcification and myocardial infarction was present in both men and women, which remained present at high age. Although results from prospective data in unselected populations have to be awaited, this study suggests that EBT is a promising tool for the detection of subjects at high-risk of coronary events in the general population.